Medicare charges more if you earn more. Here is how premiums scale with income in 2026.
How do Medicare premiums change with income?
Medicare premiums rise with income through IRMAA, a tiered surcharge on Part B and Part D. In 2026, if your modified adjusted gross income (MAGI) is at or below $109,000 (single) or $218,000 (joint), you pay the standard $202.90 Part B premium. Above that, surcharges are layered on across five income tiers, with the total Part B premium reaching $689.90 per month for the highest bracket. Part D adds a separate surcharge of $14.50 to $91.00 per month. Because of the two-year lookback, your 2026 premium reflects your 2024 income.
What if my income just crossed a threshold?
IRMAA brackets are cliffs, not gradual slopes — even one dollar over a threshold moves you into the next tier and a higher premium. That makes tax planning around the limits valuable, especially near retirement when one-time events like a Roth conversion or home sale can spike your MAGI. If a life-changing event lowered your income after 2024, file Form SSA-44 to ask Social Security to use your current income. For help understanding where you fall and how Medigap fits your budget, call 1-800-MEDIGAP (1-800-633-4427).